Probiotic formulation

ABSTRACT

A probiotic organism which is capable of proliferation in iron-rich media, an environment which is generally unfavourable to probiotic organisms, is described.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of U.S. patent application Ser. No. 14/232,852, filed Apr. 23, 2014, which is a U.S. National Stage Application of PCT International Application No. PCT/GB2012/051730, filed Jul. 19, 2012, which claims the benefit of priority to GB Application No. 1112487.2, filed Jul. 21, 2011, the disclosure of each is hereby incorporated by reference in its entirety.

FIELD

This invention relates to a probiotic formulation. More particularly, the present invention describes a probiotic organism which is capable of proliferation in an environment which is generally unfavourable to probiotic organisms.

BACKGROUND

Probiotics are organisms, generally bacteria, which are considered to be beneficial rather than detrimental to their animal host. In terms of digestive health the concept of consuming beneficial bacteria has been popular in recent years, even though the benefit of consuming specific strains of bacteria was first proposed by Elie Metchnikoff in 1907. He suggested that since lactic acid bacteria can prevent putrefaction of stored food, they may also benefit the gastrointestinal tract; Bulgarian bacillus (later identified as Lactobacillus delbruickii subspecies bulgaricus) isolated from a fermented milk product was of particular interest. Metchnikoff proposed it was the optimal strain to consume because of its ability to produce large amounts of lactic acid with little succinic or acetic acid; its ability to coagulate milk rapidly; and the lack of alcohol and acetone produced (1). Interest in probiotics waned with the advent of antibiotics. However, with the emergence of antibiotic-resistant bacteria, there is renewed interest in probiotic bacteria, which are now defined as “live microorganisms which when administered in adequate amounts confer a health benefit on the host” (2). It is now a popular concept that the accumulation of probiotic organisms in the gut is beneficial to the general health of the host organism and there are reports which indicate that the administration of probiotics is useful in the treatment of intestinal disease.

For example, following on from Metchnikoff's work, probiotics, particularly Lactobacillus spp., have been trialed in the treatment of a number of diseases. Lactobacillus spp. probiotics have also been successful in the treatment of acute infectious diarrhoea in children (3) and prevention of traveler's diarrhoea (4) and antibiotic-associated diarrhoea (AAD) (5), but not Crohn's disease (6). In contrast, two probiotic preparations which are not based upon Lactobacillus spp., VSL #3 and Escherichia coli Nissle 1917, have been reported as showing promise in the treatment of inflammatory bowel disease (IBD) (7-10). Crohn's disease is considered to be a response to an environmental trigger in a genetically susceptible host. The environmental trigger is thought to be bacteria, and current research is now focused on adherent-invasive E. coli (AIEC) (11). The present inventors considered that if Crohn's disease is indeed triggered by bacteria, then it is an attractive candidate for treatment with a probiotic which could either outcompete the triggering bacteria or could divert the immune response in order to prevent the uncontrolled inflammation which is a characteristic feature of Crohn's disease and other inflammatory bowel conditions. However, in order for any probiotic to carry out either of these functions it must be able to survive and compete within this challenging environment.

Other bacteria have been described as having iron-tolerance such as the S. thermophilus described by Sieuwerts et al (38) by Herve-Jimenez et al (39) and by Simova et al (37). However, when discussing the noted differential expression of iron transport protein genes, Sieuwerts (38) describes that this is a hydrogen peroxide response and the use of that S. thermophilus in co-culture showed no iron-responsive effect. Simova (37) describes that the presence of iron fortification or the concentration of ferrous lactate had no significant effect on the time taken to reach pH 4.5 and hence on growth rates. The present inventors tested the strain described by Herve-Jimenez et al (39) and found that this strain was not iron-responsive (strain BAA250 in FIG. 17).

In this respect the present inventors noted that the Lactobacillus spp. probiotics in general use were not generally capable of surviving and competing in the hostile environment of the inflamed intestine associated with such diseases, and especially in the presence of iron from blood in the inflamed intestine. The present inventors set out to further investigate this observation.

The lactic acid bacteria (LAB) are unusual organisms in that they do not appear to have a requirement for iron (12-14) whilst maintaining a high demand for manganese (15). In the human body, iron is sequestered by the transferrins and lactoferrin (16). Iron sequestration is considered the primary factor limiting bacterial growth rate in the body. An increase in the availability of iron in the intestine by dietary supplementation, intestinal bleeding, surgery, trauma or when under stress, will lead to an increase in the abundance of many bacterial species. This is mediated by a greater availability of free iron, or by the presence of noradrenaline, which unloads iron from chelators and can supply it to some species of bacteria (17-18). Under these high-iron conditions, LAB are rapidly outcompeted as other species increase their growth rate in response to iron availability and predominate. Thus, the present inventors determined that for adequate or therapeutic levels of probiotic bacteria to be maintained under high iron conditions, they must be able to respond to this element by increasing growth rate in order to compete with the normal flora. They then postulated that an inability to compete with potential pathogens under conditions of stress and trauma, and especially under those conditions which result in increased iron levels, may contribute to the lack of efficacy shown by many LAB-based probiotics in treating disease.

DETAILED DESCRIPTION

As will be described below, the present inventors have shown that the majority of LAB do not respond to noradrenaline-mediated iron availability by increasing growth rate. Many intestinal diseases, both chronic and acute, are associated with intestinal bleeding which will lead to higher levels of iron being present in the intestine. Therefore, this will not present a suitable environment for colonisation by conventional LAB-based probiotics, further contributing to the lack of efficacy seen with many conventional LAB-based probiotics in treating such diseases.

Having identified this previously unseen problem, the present inventors then investigated the possibility of identifying a probiotic which was in fact able to increase growth rate in response to iron availability. The present inventors thus identified and selected species of bacteria that can increase growth rate under these conditions.

Accordingly, the present invention provides a Streptococcus thermophilus spp. which is able to increase growth rate in response to increased iron availability especially in a competitive in vivo environment where there is competition for food and other requirements for growth and reproduction.

Advantageously, the Streptococcus thermophilus spp. of this invention present an alternative to the traditional LAB spp. probiotics because they are, in fact, active and functional in the mixed culture population encountered in the true gut environment even during periods of increased iron concentration from intestinal bleeding, trauma, stress or other factors. Hence, the Streptococcus thermophilus spp. of the present invention are suitable for use in the treatment of intestinal diseases in general, and especially for use in those diseases associated with or complicated by elevated iron levels resulting from, for example, the presence of blood due to intestinal bleeding or leaking epithelia or from the presence of supplemented iron from a nutritional supplement or fortified food.

The Streptococcus thermophilus spp. of the present invention is preferably able to sustain its increase in growth rate in a mixed population environment in the presence of iron for more than one day and more preferably for several days. It is preferred that the Streptococcus thermophilus spp. of the present invention is able to grow and compete with other gut bacteria, such as commensal organisms but especially in the presence of pathogenic bacteria, at the concentrations of iron which may be encountered during periods of intestinal bleeding.

In a most preferred embodiment the Streptococcus thermophilus spp. is able to survive, reproduce and grow in an iron-rich growth medium in the presence of other organisms for a time equivalent to that of normal digestive transit, such as at least one and up to three days. More preferably, the Streptococcus thermophilus spp. of the present invention is able to grow in the presence of endogenous and pathogenic bacteria in a hostile or diseased gut environment as well as in a healthy gut environment. A “hostile” gut environment is intended to describe a gut environment in which probiotic organisms generally struggle to compete with other organisms and hence either have a lower growth rate or are unable to survive. Examples, not intended to be limiting, of a hostile gut environment, include the presence of blood, the presence of artificially induced levels of minerals, especially iron, and vitamins, for example from a supplement, the presence of chelating agents, the presence of drugs or other medications which impact on the gut environment, changes caused by chronic gastro-intestinal disease, and changes induced hormonally, such as stress.

It is preferred that the Streptococcus thermophilus spp. of the present invention is tolerant of low pH to enable passage through the stomach during digestion and accordingly it is preferred that the Streptococcus thermophilus spp. is able to survive at a pH of 2. More preferably, the Streptococcus thermophilus spp. is able to survive at a pH below 2 such as 1.5 or even lower. Even more preferably, this is achieved in a mixed population environment such as that encountered in vivo. Alternatively, to overcome problems associated with low gastric pH, the Streptococcus thermophilus spp. may be provided in a formulation which is in itself resistant to low gastric pH, such as being provided with a digestion-resistant or enteric coating especially when in tablet or capsule form. Such a coating may be of conventional type for a capsule, tablet or the like for oral delivery.

In a most preferred embodiment the Streptococcus thermophilus spp. is able to survive, reproduce and grow in a low pH growth medium equivalent to typical gastric pH for at least the time typical of gastric transit, which is about two hours. Even more preferably, this is achieved in a mixed population environment such as that encountered in vivo.

The Streptococcus thermophilus spp. of the present invention is known by the internal designation of Streptococcus thermophilus JB010. Streptococcus thermophilus JB010, the preferred Streptococcus thermophilus spp. of the invention, may be identified by whole or partial DNA sequencing, such as randomly amplified polymorphic DNA (RAPD) analysis where the primers M13 and MSP were used to randomly amplify DNA fragments from S. thermophilus strains. The unique banding pattern generated by S. thermophilus JB010 demonstrates genetic differences between this strain and all other strains examined. This shows that the Streptococcus thermophilus spp. of the present invention is different than the commercially available strain VSL #3. The details of this RAPD analysis will be set out in more detail in the Examples which follow.

The Streptococcus thermophilus spp. of the present invention has been deposited with the NCIMB Ltd. (Ferguson Building Craibstone Estate, Bucksburn, Aberdeen, AB21 9YA UK, an International Depositary Authority registered under the Budapest Treaty) on Jul. 6, 2011, under the accession number NCIMB 41856.

Hence, the present invention also provides the Streptococcus thermophilus NCIMB 41856.

The Streptococcus thermophilus spp. of the present invention may be provided in a composition suitable for use as a food, a food supplement, a nutraceutical or as a therapeutic. Such a composition may be based on a milk product, as is conventional for probiotics. The milk product is preferably a fermented milk product such as yoghurt. The composition may contain the Streptococcus thermophilus spp. as the sole probiotic ingredient, as the major probiotic, or may contain a mixture of probiotics. Non-dairy formulations, formulations based on milk-alternatives such as soya milk and yoghurts, fruit-based formulations and the like are also contemplated as food supplements. Especially where the composition is a food supplement, the composition may comprise other ingredients such as flavourings or other conventional food ingredients to improve the taste, palatability, texture or other organoleptic properties of the composition.

Alternatively, the Streptococcus thermophilus spp. of the present invention may be provided in the form of a powder, capsule, tablet or the like, and hence the conventional ingredients for that delivery system will be present, for example, gelatin, cellulose, starches, excipients, binders, flavours, anti-caking agents, preservatives and other pharmaceutically acceptable delivery vehicles and ingredients.

Accordingly, the present invention provides a food, a food supplement, nutraceutical or a therapeutic comprising a Streptococcus thermophilus spp. which is able to increase growth rate in response to iron availability.

More specifically, the present invention provides a food, a food supplement, nutraceutical or a therapeutic comprising Streptococcus thermophilus NCIMB 41856.

It is envisaged that the present invention will be usable in the treatment of intestinal diseases, especially those associated with an increase in the availability of iron in the intestine due to intestinal bleeding, surgery, trauma or under stress. Such diseases may be chronic, for example, inflammatory bowel diseases, such as Crohn's disease or ulcerative colitis, irritable bowel syndrome, coeliac disease, gastroenteritis or pancreatitis, or they may be acute such as injury, surgery, infection (for example C. difficile infection), or infestation by protozoa or worms.

The food, food supplement, nutraceutical or a therapeutic may be provided in a formulation suitable for use in humans or in animals.

In a most preferred embodiment the Streptococcus thermophilus spp. of the present invention is also able to act locally to reduce the level of chronic inflammation in the gut. This is preferred since it allows the adaptive immune system to clear any infection in a controlled manner and promotes regulation and resolution of gut inflammation.

The mechanisms through which probiotics have been hypothesised to act are numerous and include an influence on intestinal transit time, competition with pathogens and immune modulation. It is not clear what effect on the immune system is most desirable. A pro-inflammatory response may be required in order to more effectively clear infection (19-20), however prolonged NF-κB activation, and subsequent production of IL-8, RANTES and CXCL10, has been implicated in animal models of IBD (21). In contrast, probiotic strains of bacteria have been shown to act specifically on components of the adaptive immune response in order to reduce inflammation and promote regulation. Faecalibacterium prausnitzii is a probiotic strain capable of reducing the expression of the pro-inflammatory cytokines IL-12 and IFNγ by PBMCs (22). Upregulation of regulatory IELs in a mouse model of colitis was induced by two mixtures of probiotics: L. acidophilus and B. longum; L. plantarum, S. thermophilus and B. animalis subsp. lactis (23). Furthermore, a combination of L. acidophilus, L. casei, L. reuteri, B. bifidum and S. thermophilus downregulated Th1, Th2, and Th17 cytokine responses, induced generation of CD4⁺ Foxp3 Tregs, and promoted regulatory dendritic cells expressing high levels of the regulatory cytokines IL-10 and TGFβ (24).

As set out above, LAB have uniquely very low requirements for iron (12-14). The increased bioavailability of iron during intestinal bleeding can increase the growth rate and virulence of many gastrointestinal pathogens (25); under these conditions, LAB can be outcompeted. The results obtained by the present inventors indicate that most LAB cannot respond to increased iron bioavailability (see Table 1 below), with the exception of Lactobacillus acidophilus ASF360 and the Strep. thermophilus of the present invention, Streptococcus thermophilus NCIMB 41856. It is thought that one of the principal mechanisms for the action of probiotics is competitive exclusion of pathogens. The results of the present inventors support their theory that LAB-based probiotics are inefficient during active inflammatory disease because of their inability to compete with pathogens in the presence of iron, due to bleeding or supplementation.

For a probiotic to be effective in treating IBD, the present inventors consider that it must be able to effectively compete with pathogens under the conditions encountered in the non-healthy intestine. It should also be able to control immune responses to pathogens and restore normality. These are the primary properties that were investigated in this work. Using a rational selection process, the present inventors determined that the iron-responsive strain of S. thermophilus NCIMB 41856 shows probiotic potential. This S. thermophilus NCIMB 41856 performed at least as well, and in many cases, better than, the more widely researched strains of L. acidophilus and E. coli Nissle 1917. E. coli is known to be able to respond to iron (25), and the present inventors have shown that S. thermophilus JB010 (NCIMB 41856) can also respond to iron (Table 1). However, whereas the present inventors have now found that S. thermophilus JB010 (NCIMB 41856) promoted an anti-inflammatory response, they found that, consistent with the findings of other groups (26), E. coli Nissle 1917 provoked a pro-inflammatory response from gut and gut-derived cells and cell lines. The present inventors have hypothesised that activation of epithelial cells, as demonstrated here by the ability of E. coli Nissle 1917 to induce an NF-κB and IL-8 response, leads to an increase in innate immune defences, thereby improving barrier function (27). However, concerns have been raised about the safety of E. coli Nissle 1917 as a probiotic, particularly in immunocompromised patients (28).

The results presented here show that the present inventors' strain of S. thermophilus (NCIMB 41856, also designated JB010) is a promising probiotic in the in vitro experiments. S. thermophilus has largely been overlooked as a probiotic strain of bacteria in favour of Lactobacillus or Bifidobacterium spp., and little work has been done to determine the mode of action of this probiotic. Despite this, S. thermophilus spp. is a constituent of the VSL #3 probiotic preparation, which is one of the few probiotic therapies to have a significant effect on the treatment of IBD (10). The advertising literature for VSL #3 suggests that it is the combination or blend of the eight strains of bacteria which make up VSL #3, together with the increase in the numbers of bacteria present in a single dose of the product, which provide this beneficial effect by providing the “optimal intestinal flora”. Additionally, the present inventors have shown that the S. thermophilus present in VSL #3 is not iron-responsive in the same manner as the S. thermophilus NCIMB 41856 of the present invention.

The present inventors have also shown by RAPD DNA analysis, as described below, that their strain of S. thermophilus (Streptococcus thermophilus NCIMB 41856) is not the same as that present in VSL #3 (see FIG. 10 which shows the difference in the DNA analysis between the two).

The present inventors have also determined the partial gene sequences of the sodA, dpr, 16S and rpoB genes of Streptococcus thermophilus NCIMB 41856 and have determined, by alignment, that they differ from the same sequences in the lactic acid bacteria strains LMG 18311, CNRZ1066, JIM 8232, and VSL #3 (See FIGS. 11-16). The sodA and dpr genes have been associated with iron and/or manganese usage in bacteria, especially LAB, while the 16S and rpoB genes are representative of bacterial lineage.

S. thermophilus is also present in the majority of fermented milk products, some of which have been successfully used as therapeutic treatments (29); however, the levels of this bacterial spp. present in those products are too low to have a probiotic effect (30). The present inventors have found that the beneficial effect exerted by Streptococcus thermophilus NCIMB 41856 is dose-dependent, with the optimum in vitro dose being 1000 times more concentrated than that found in the majority of fermented milk products previously trialed. Few studies have looked into the probiotic effect of S. thermophilus alone; however, it was reported that milk fermented with this strain of bacteria was equivalent to proton-pump inhibitors in reducing gastritis induced by non-steroidal anti-inflammatory drugs (31).

The present inventors believe that the predominant effect of S. thermophilus JB010 (NCIMB 41856) would be in reducing inflammation in the gut, firstly exerting its effects from the lumen of the gut and secondly, when intestinal barrier function is compromised, by crossing through the epithelium and interacting with the underlying cells. Here the present inventors have shown that this probiotic strain of bacteria is capable of reducing epithelial cell death as well as the NF-κB and IL-8 response to pathogen, thereby limiting the pro-inflammatory response initiated by the innate immune system. Furthermore, it acts on the adaptive immune system by modulating the T cell response, promoting regulation and reducing inflammation. The pro-inflammatory response to pathogenic E. coli was essentially cancelled out by the addition of Streptococcus thermophilus NCIMB 41856, returning levels of the varying T cell subsets to those seen under normal conditions in the present inventors' ex vivo system. This was further emphasised by the ability of S. thermophilus JB010 (NCIMB 41856) to reduce the transcription of mRNA encoding TNFα in response to AIEC. As previously mentioned, AIEC has been implicated in the pathogenesis of Crohn's disease; therefore the ability of S. thermophilus JB010 (NCIMB 41856) to reduce the production of TNFα, the principle pro-inflammatory cytokine present in this condition, is highly important.

In conclusion, S. thermophilus JB010 (NCIMB 41856) is an iron-responsive probiotic strain of bacteria with far-reaching applications, capable of reducing egress of pathogenic bacteria from the lumen of the gut, improving barrier function, and reducing gut inflammation.

Accordingly, in a second aspect, the present invention provides a Streptococcus thermophilus spp. which is able to act locally to reduce the level of chronic inflammation in the gut.

Hence, the present invention provides Streptococcus thermophilus NCIMB 41856 for use in a medicament for the reduction of chronic inflammation in the gut.

In a preferred embodiment, the same Streptococcus thermophilus spp. is also able to increase growth rate in response to iron availability. Preferably, this is Streptococcus thermophilus NCIMB 41856.

In the most preferred embodiment, the two aspects of the invention are provided by the same probiotic, Streptococcus thermophilus NCIMB 41856.

BRIEF DESCRIPTION OF THE DRAWINGS

The patent or application file contains at least one drawing executed in color. Copies of this patent or patent application publication with color drawing(s) will be provided by the Office upon request and payment of the necessary fee.

Embodiments of the invention will now be described with reference to and as illustrated by the accompanying drawings.

FIG. 1 is a series of graphs illustrating the effect of probiotics on proliferation and death of epithelial cells in response to pathogenic E. coli. a) proliferation of T84 cells; b) proliferation of Caco-2 cells; c) death of T84 cells; d) death of Caco-2 cells. Results are shown from 3 replicate experiments and are expressed as mean±S.E.M. * p≤0.05, ** p≤0.01 and *** p≤0.001.

FIG. 2 is a series of graphs further detailing the results shown in FIG. 1 for Caco-2 cells illustrating the change in TEER in response to E. coli and the effect of probiotic on this response. * p≤0.05, ** p≤0.01 and *** p≤0.001.

FIG. 3 is a series of graphs further detailing the results shown in FIG. 1 for T84 cells illustrating the change in TEER in response to E. coli and the effect of probiotic on this response. * p≤0.05, ** p≤0.01 and *** p≤0.001.

FIG. 4 is a series of graphs illustrating the effect of probiotics on NF-kB (a) and IL-8 (b) response to pathogen. Results are shown from 6 replicate experiments and are expressed as mean±S.E.M. * p≤0.05, ** p≤0.01 and *** p≤0.001.

FIG. 5 is a series of graphs illustrating the percent change in cytokine mRNA levels induced by T cells in response to E. coli with and without probiotic. Results are expressed as mean±S.E.M. * p≤0.05.

FIG. 6 is a series of graphs illustrating the translocation of bacteria through a Caco-2 or T84 epithelial cell monolayer. Results are shown from 3 replicates and are expressed as means. * p≤0.05, ** p≤0.01 and *** p≤0.001.

FIG. 7 is a series of photographs showing the expression of occludin (red in colour originals; light grey in black and white) in epithelial cell monolayers (a). Proportion of pixels positive for occludin staining relative to entire field of view (b). Results are expressed as mean±S.E.M. * p≤0.05 and ** p≤0.01.

FIG. 8 is a series of graphs illustrating the percent change in expression of T-box21 (Th1), RORC (Th17), and Foxp3 (Treg) transcription factor mRNA in response to E. coli and the effect of probiotics on their expression. Results are expressed as mean±S.E.M. * p≤0.05 and ** p≤0.01.

FIG. 9 is a series of graphs illustrating the percent change in cytokine mRNA levels induced by T cells in response to E. coli with and without probiotic. Results are expressed as mean±S.E.M. * p≤0.05 and ** p≤0.01.

FIG. 10 is a photograph of a gel showing the DNA fragments produced following RAPD PCR.

FIG. 11 shows the sequence listing of the soda (SEQ ID NO:1), dpr (SEQ ID NO:2), 16S (SEQ ID NO:3), and rpoB (SEQ ID NO:4) genes of Streptococcus thermophilus NCIMB 41856.

FIG. 12 shows the comparative alignment of the sodA gene of the lactic acid bacterial strains LMG 18311, CNRZ1066, JIM 8232, VSL #3, and JMB010 (Streptococcus thermophilus NCIMB 41856).

FIG. 13 shows the comparative alignment of the dpr gene of the lactic acid bacterial strains LMG 18311, CNRZ1066, JIM 8232, VSL #3, and JMB010 (Streptococcus thermophilus NCIMB 41856).

FIG. 14 shows the comparative alignment of the 16S gene of the lactic acid bacterial strains LMG 18311, CNRZ1066, JIM 8232, VSL #3, and JMB010 (Streptococcus thermophilus NCIMB 41856).

FIG. 15 shows the comparative alignment of the rpoB gene of the lactic acid bacterial strains LMG 18311, CNRZ1066, JIM 8232, VSL #3, and JMB010 (Streptococcus thermophilus NCIMB 41856).

FIG. 16 shows the specific base changes between the lactic acid bacterial strains LMG 18311, CNRZ1066, JIM 8232, VSL #3, and JMB010 (Streptococcus thermophilus NCIMB 41856) in the sodA, dpr, 16S and rpoB (lineage) genes.

FIG. 17 is a graph showing the growth response rates of JMB010 (Streptococcus thermophilus NCIMB 41856) and VSL #3 and BAA-250 in the presence of iron where the blue line (*) defines the mean level of iron in faeces of people not taking iron supplements, and the red line (**) defines the mean level of iron in the faeces of people taking iron supplements, and the dotted lines represent the level of iron used to fortify yoghurt in the description of Simova et al (37).

FIG. 18 is a graph showing the adherence of the bacterial strains S. thermophilus JB010 (Streptococcus thermophilus NCIMB 41856), S. thermophilus JB021, E. coli K12, E. coli HM427, and E. coli HM615 to Caco-2 cells.

EXAMPLES

Bacteria

Species of lactic acid bacteria that have been employed as probiotics were used. These were: L. bulgaricus JB005, L. casei JB006, L. casei JB008, B. animalis JB007, and B. bifidum JB009 (isolated from yoghurt by the present inventors); L. plantarum JB011 and L. helveticus JB012 (isolated by the present inventors from probiotic capsules); and the commensal isolates L. acidophilus ASF360 and L. salivarius ASF361 (components of the Schaedler flora). Two strains of S. thermophilus (JB004 and JB010 [Streptococcus thermophilus NCIMB 41856]) were isolated from yoghurt by the present inventors. Two strains of AIEC were used: HM427 and HM615 (kindly provided by Dr Barry Campbell and Prof Jon Rhodes, University of Liverpool), as was E. coli K12 and E. coli Nissle 1917 (isolated from Mutaflor (Ardeypharm GmbH, Herdecke, Germany)). All E. coli strains were grown in 10 ml volumes of LB broth (Oxoid, Cambridge, UK) at 37° C. overnight. S. thermophilus was grown in M17 broth supplemented with lactose (Oxoid), and Lactobacillus spp. were cultured in MRS broth (Oxoid) overnight in a microaerobic atmosphere. Lactic acid bacteria were cultured in serum-SAPI medium with and without 100 μM (−) noradrenaline (Sigma, Poole, UK) in order to determine if they were capable of responding to it. O.D. measurements were taken at 24, 48, and 72 hours in order to determine bacterial growth. Differences were analysed using a repeated-measures ANOVA.

Identification of Streptococcus thermophilus NCIMB 41856

The Streptococcus thermophilus spp. NCIMB 41856 was determined to be different to the known from VSL #3 strain by using randomly amplified polymorphic DNA (RAPD) analysis where the primers M13 and MSP were used to randomly amplify DNA fragments from various S. thermophilus strains. The unique banding pattern generated by S. thermophilus NCIMB 41856 demonstrates genetic differences between this strain and all other strains examined, including VSL #3 (see FIG. 10).

RAPD

The analysis of randomly amplified polymorphic DNA (RAPD) is a technique used to determine interspecies differences in S. thermophilus isolates. Two sets of previously described primers, M13 and MSP (36), were used collectively to produce random fragments which generate a characteristic fingerprint pattern following gel electrophoresis. DNA was extracted from S. thermophilus isolates by resuspending a small sweep of colonies in 500 μl nuclease-free water and heating to 100° C. for 10 minutes. PCR was performed using GoTaq Hot Start Polymerase (Promega), 0.2 μM of each primer and 5 μl DNA in a final volume of 25 μl per reaction. Magnesium chloride concentrations were adjusted to 7.2 mM in the final reaction by the addition of 50 mM MgCl₂. Sample incubations were performed in a DNA Engine DYAD Peltier Thermal Cycler (MJ Research) at 95° C. for 2 minutes and then 60 cycles of 94° C. for 30 seconds, 45° C. for 30 seconds and 72° C. for 80 seconds followed by a final period of 4 minutes at 72° C. PCR products were run out on a 1.5% agarose gel in order to visualise DNA fragments. The results are shown in FIG. 10 in which the control is the PCR mix water and contains a band amplified from residual E. coli DNA present in the PCR mix.

Proliferation and Death of Epithelial Cells

Increased turnover of epithelial cells is a common response to infection, therefore we assessed the effect of pathogenic E. coli on the proliferation and death of epithelial cell lines and the effect of probiotic on this. All cell culture reagents were purchased from PAA Laboratories (Austria) unless otherwise specified. T84 (an intestinal cell metastasised to the lung) and Caco-2 (colonic) human adenocarcinoma cells were grown in DMEM/Ham's F-12 or DMEM respectively, supplemented with 10% FCS, 2 mM L-glutamine and 100 U/ml penicillin/streptomycin in 96-well tissue culture plates at an initial density of 2.4×10⁴ cells per well. After 3 days incubation, the medium was changed for one that was antibiotic-free and cells were labelled with BrdU in order to quantify proliferation. Bacteria were added to the epithelial cell cultures at an MOI of 30 and incubated for 24 hours at 37° C. with 5% CO₂. After 24 hours, supernatants were harvested to determine cytotoxic effects of bacteria using the Cytotox 96 non-radioactive cytotoxicity assay kit (Promega, Southampton, UK) as directed by the manufacturer's instructions. Quantification of BrdU incorporation into the cells was determined using the cell proliferation biotrack ELISA system (GE Healthcare, Chalfont St Giles, UK) as per the manufacturer's instructions. Differences were analysed using paired t-tests (GraphPad Prism 5, California, USA).

NF-κB Assays

NF-κB is activated downstream of TLR signalling in epithelial cells and plays a key role in regulating the immune response to infection, particularly inducing a pro-inflammatory response. In order to determine the effect of pathogen and probiotic on this pro-inflammatory signal, NF-κB activity was measured by luciferase assays. Caco-2 cells (colonic human adenocarcinoma cells) were seeded into 12-well tissue culture plates at an initial density of 6×10⁵ cells per well. After 2 days of culture, cells were transfected with a reporter plasmid having an NF-κB response element, pGL4.32 (Promega), and the internal control reporter pGL4.74 (Promega) using lipofectamine (Invitrogen, California, USA). 24 hours later, the medium was replaced with 1×HBSS (Invitrogen) and bacteria were added at an MOI of 30. After 40 hours, cells were lysed and luciferase activity was quantified using a Dual Luciferase Reporter Assay (Promega) as per the manufacturer's instructions. Differences were analysed using paired t-tests (GraphPad Prism 5). T84 cells could not be efficiently transfected using these reporter plasmids and therefore results are not shown.

Detection of IL-8

IL-8 is released by epithelial cells subsequent to NF-kB signalling and its release causes the recruitment of inflammatory cells. In order to determine the effect of potential probiotic strains on IL-8 production, T84 cells were seeded into 12-well tissue culture plates at an initial density of 6×10⁵ cells per well. After 3 days of culture, the medium was replaced with antibiotic-free medium and bacteria added at an MOI of 30. After 6 hours supernatants were harvested. Cytotoxicity was determined as above and production of IL-8 was quantified by ELISA using the human IL-8/CXCL8 DuoSet (R&D Systems, Minneapolis, USA) as per the manufacturer's instructions. IL-8 production was corrected for cell death and differences were analysed using paired t-tests (GraphPad Prism 5). Caco-2 cells did not produce sufficient levels of IL-8 and therefore results are not shown.

Growth of Epithelial Cell Monolayers and Challenge with Bacteria

In order to determine whether the present inventors' candidate probiotic strains could cross the epithelial barrier and whether they had any effect on the passage of pathogenic E. coli strains, Caco-2 and T84 cells were seeded onto 12-mm Transwell membranes (12 mm diameter, 3 μm pore size; Corning Glass Works, Corning, N.Y.) in 12-well tissue culture plates at an initial density of 3×10⁵ cells per insert. Plates were incubated at 37° C. in 5% CO₂ for 8-10 days until the cells formed confluent monolayers and the transepithelial resistance (TEER) was greater than 300 Ω/cm² as measured with an epithelial voltmeter as an indicator of membrane permeability. The medium was then changed to one that was antibiotic free and bacteria were added to the apical well of the Transwell insert at an MOI of 30. TEER of all monolayers was measured at 2 hour intervals up to 12 hours and bacteria in the basal well were enumerated every 2 hours up to 10 hours. Differences were evaluated at each time point using paired t-tests (GraphPad Prism 5). In a separate experiment, medium was removed from the Transwells after 10 hours and the monolayers were examined as detailed below.

Occludin Staining

Occludin is a component of almost all tight cell junctions, therefore in order to determine tight junction breakdown Transwell inserts were fixed in ice-cold methanol at 4° C. overnight. Inserts were washed in PBS and the cells permeabilised with 0.1% Triton X-100 for 10 minutes before being washed again. Mouse anti-occludin monoclonal antibody (Zymed, California, USA) was diluted 1/200 and added to the apical chamber of the insert and incubated at room temperature for 45 minutes. Inserts were then washed in PBS and incubated for a further 45 minutes with TRITC-conjugated isotype-specific goat anti-mouse antibody (Southern Biotech, Birmingham, Ala., USA) diluted 1/100 in the apical chamber. The inserts were then washed with PBS and the membranes were cut out of the inserts with a scalpel and mounted on slides with Vectashield containing DAPI (Vector Laboratories, California, USA). Fluorescent staining was examined on a Leica DMRA microscope equipped with a Hamamatsu Orca-ER monochrome camera. Ten fields of view per slide at 40× magnification were digitised using Leica Q-Fluoro software. Images were viewed using ImageJ software (rsb.info.nih.gov) and positive pixels automatically counted as previously described (32). The significance of differences was determined by one-way ANOVA (GraphPad Prism 5).

T Cell Isolation and Culture

Intestinal lamina propria leukocytes were isolated in order to determine the effect of pathogenic E. coli strains and potential probiotics on the adaptive immune response. Resected intestinal tissue was collected from patients undergoing surgery for complications associated with Crohn's disease or ulcerative colitis and from patients with colorectal cancer after informed consent and with appropriate ethical approval. The mucosa was separated from the muscle, cut into small fragments and incubated in collagenase (100 U/ml; Sigma) for 2 hours at 37° C. Cells were washed in PBS and leukocytes purified over discontinuous Percoll gradients (35-75%; GE Healthcare). The cell count and viability was determined by trypan blue exclusion. Cells were resuspended to a final concentration of 5×10⁶/ml in RPMI 1640 supplemented with 10% FCS, 1 mM sodium pyruvate, 2 mM L-glutamine and 50 μg/ml gentamicin and cultured on top of a type I collagen gel (PureCol; Nutacon BV, The Netherlands). It has previously been shown that co-culture of lamina propria T cells with ECM components prevents activation-induced apoptosis (33) and, in particular, ligation of β₁ integrins (34); type I collagen is used as a supporting material in order to allow leukocytes to survive and proliferate. Bacterial cell sonicates were added to each well at an equivalent concentration to an MOI of 30 and cells were cultured for 5 days at 37° C. with 5% CO₂. After 5 days leukocytes were liberated from the collagen gel by the addition of collagenase (1000 U/ml). Cells were washed and counted before RNA extraction.

RT-qPCR

RT-qPCR was used to determine the relative expression of mRNA relating to Th1, Th2, Th17, and Treg responses and associated cytokines. RNA was extracted from the cultured leukocytes using a Macherey-Nagel NucleoSpin RNA II Isolation Kit (ABgene, Epsom, UK). Synthesis of cDNA was carried out using 500 ng of random hexamers using the ImProm-II Reverse Transcription System (Promega) in a final volume of 20 μl. All reactions were prepared according to the manufacturer's instructions giving a final magnesium chloride concentration of 3 mM. All cDNAs were diluted to a final volume of 100 μl (1/5 dilution) using EB buffer (10 mM Tris HCl pH 8.4; Qiagen Ltd., Crawley, UK). Primers and probes were designed using Primer 3 (rodo.wi.mit.edu/primer3) and M-Fold using the human specific GenBank sequences for T-box21 (accession number NM_013351), GATA-3 (accession number NM_001002295), RORC (accession number NM_005060), Foxp3 (accession number NM_017009), IFNγ (accession number NM_000619), TNFα (accession number NM_000594), IL-4 (accession number NM_000589), IL-4δ2 (accession number NM_172348), IL-17A (accession number NM_002190), IL-10 (accession number NM_000572) and TGFβ (accession number NM_000660). The housekeeper gene hydroxymethylbilane synthase (HMBS) was used as an internal control. Quantitative PCR (qPCR) was performed using HotStarTaq Master Mix (Qiagen Ltd.). Gene specific amplification was performed using 0.2 μM of each primer, 0.1 μM of probe or SYBR Green 1 (1/100,000; Sigma) and 5 μl of diluted cDNA in a final volume of 25 μl. Magnesium chloride concentrations were adjusted to 4.5 mM in the final reaction by addition of 50 mM MgCl₂. Sample incubations were performed in an MxPro3005P (Stratagene, California, USA) at 95° C. for 15 minutes and then 45 cycles of 95° C. for 15 seconds, and 60° C. for 30 seconds during which the fluorescence data were collected. Data is expressed as the relative change in mRNA transcription following treatment and is normalised for cell number. No significant differences were seen between cells isolated from the three disease states and therefore results were pooled for analysis. Differences were analysed using paired t-tests (GraphPad Prism 5).

Growth of Bacteria with Noradrenaline

Noradrenaline can remove iron from chelators and supply it to bacteria. A number of LAB were cultured with and without noradrenaline to determine whether they were capable of responding to it, or the iron provided by it (Table 1). While the addition of noradrenaline had no effect on most LAB studied, two strains significantly increased their growth in response to it: L. acidophilus ASF360 increased its growth more than 7-fold at 48 hours, and S. thermophilus JB010 (NCIMB 41856) increased growth at all time points studied, with a maximum of an almost 5-fold increase at 48 hours (Table 1). These two strains were chosen for further characterisation of their probiotic potential, alongside E. coli Nissle 1917 which has been used for the treatment of IBD (7). * indicates that growth rate for the strain is significantly greater than the average for all strains at that time point.

TABLE 1 Response of lactic acid bacteria to noradrenaline 24 Hours 48 Hours 72 Hours L. bulgaricus JB005 1.227 ± 0.215 1.328 ± 0.279 1.266 ± 0.125 L. casei JB006 0.848 ± 0.144 1.191 ± 0.180 1.440 ± 0.017 L. casei JB008 1.140 ± 0.074 1.035 ± 0.125 1.357 ± 0.446 L. acidophilus ASF360 1.285 ± 0.179 7.725 ± 2.519 * 2.375 ± 0.937 L. salivarius ASF361 1.021 ± 0.128 0.865 ± 0.175 1.187 ± 0.173 L. plantarum JB012 1.014 ± 0.170 0.943 ± 0.115 1.112 ± 0.250 L. helveticus JB011 0.999 ± 0.114 1.003 ± 0.097 1.004 ± 0.214 B. animalis JB007 0.998 ± 0.313 1.246 ± 0.398 1.037 ± 0.326 B. bifidum JB009 1.175 ± 0.134 1.209 ± 0.172 1.190 ± 0.169 S. thermophilus JB004 0.986 ± 0.296 1.374 ± 0.109 1.576 ± 0.439 S. thermophilus 1.700 ± 0.242 * 4.798 ± 0.868 * 3.869 ± 1.954 * NCIMB 41856 Proliferation and Death of Epithelial Cells

T84 and Caco-2 adenocarcinoma cells were incubated with the potential probiotics L. acidophilus ASF360, S. thermophilus JB010 (NCIMB 41856), and E. coli Nissle 1917 to determine their effect on the proliferative or apoptotic cellular response to pathogenic E. coli strains, K12 and the Crohn's disease-associated AIEC strain HM615 (35). All E. coli strains, including E. coli Nissle 1917, reduced the proliferation of T84 epithelial cells: E. coli K12 reduced proliferation by 78% compared to untreated cells (p=0.002); AIEC HM615 reduced proliferation by 80% (p=0.0001); and E. coli Nissle 1917 by 82% (p=0.001) (FIG. 1). A similar reduction in proliferation of Caco-2 cells was seen following E. coli treatment: E. coli K12 induced a reduction of 77% compared to untreated cells (p=0.003); AIEC HM615 induced a reduction by 76% (p=0.003); and E. coli Nissle 1917 by 78%, (p=0.004) (FIG. 1). Simultaneously, cell death was increased in both T84 and Caco-2 cells; E. coli K12 induced a 254% increase in cell death in Caco-2 cells (p=0.0005); AIEC HM615 induced a 498% increase in death in T84 cells (p=0.0003) and a 254% increase in Caco-2 cell death (p=0.001); E. coli Nissle 1917 induced a 498% increase in T84 cell death (p<0.0001) and a 218% increase in Caco-2 cell death (p=0.001) (FIG. 1). S. thermophilus JB010 (NCIMB 41856) reduced the proliferation of Caco-2 cells treated with E. coli K12 or AIEC HM615 by 35% (p=0.003) and 31% (p=0.05), respectively; while E. coli Nissle 1917 reduced proliferation induced by E. coli K12 by 32% (p=0.007) and 37% in response to AIEC HM615 treatment (p=0.03) (FIG. 1). In addition, L. acidophilus ASF360 further reduced proliferation of Caco-2 cells treated with AIEC HM615 by 22% (p=0.02) (FIG. 1). S. thermophilus JB010 (NCIMB 41856) reduced proliferation of T84 cells treated with AIEC HM615 and E. coli Nissle 1917 by 33% (p=0.03) and 48% (p=0.03), respectively (FIG. 1). Importantly, all three probiotic strains reduced death of Caco-2 cells following challenge with both E. coli K12 and HM615: L. acidophilus ASF360 reduced death of epithelial cells by 14% (p=0.04) following E. coli K12 treatment and 16% following infection with AIEC HM615 (p=0.03); S. thermophilus JB010 (NCIMB 41856) reduced death of epithelial cells following E. coli K12 and AIEC HM615 treatment by 10% (p=0.01) and 18 (p=0.007), respectively; E. coli Nissle 1917 reduced death of epithelial cells following E. coli K12 and treatment by 26% (p=0.006) and 27% (p=0.003), respectively (FIG. 1). In addition, S. thermophilus JB010 (NCIMB 41856) was able to reduce proliferation and cell death of untreated Caco-2 cells by 24% (p=0.008) and 22% (p=0.02) respectively (FIG. 1).

Induction of NF-κB and IL-8

Monolayers of Caco-2 and T84 cells were treated with the three potential probiotic bacterial strains in combination with pathogenic E. coli strains in order to determine the effect of probiotic on either of these pro-inflammatory signalling events. NF-κB signalling in Caco-2 cells was upregulated by 491% (p=0.002) compared to controls following infection with E. coli K12 and by 247% (p=0.002) following AIEC HM427 treatment. However, this induction was reduced by the addition of all three probiotic strains: L. acidophilus ASF360 reduced the NF-κB response to E. coli K12 by 50% (p=0.006) and AIEC HM427 by 28% (p=0.007); S. thermophilus JB010 (NCIMB 41856) reduced the NF-κB response to E. coli K12 by 58% (p=0.002) and AIEC HM427 by 49% (p=0.005); and E. coli Nissle 1917 reduced the NF-κB response to E. coli K12 by 79% (p=0.0005) and AIEC HM427 by 68% (p=0.004) (FIG. 4). 41856) also reduced NF-κB signalling by 48% in untreated cells (p=0.003) (FIG. 4). Following NF-κB signalling, IL-8 production was increased by 1566% in response to E. coli K12 (p=0.001), 1104% in response to AIEC HM427 (p=0.004) and 363% in response to HM615 (p=0.02), as well as a 1498% increase following addition of E. coli Nissle 1917 (p=0.004). The IL-8 response to E. coli K12 was reduced by 22% following addition of S. thermophilus JB010 (NCIMB 41856) (p=0.02) and the response to AIEC HM427 was reduced by both L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) by 17% (p=0.02) and 39% (p=0.02) respectively (FIG. 4).

Maintenance of Epithelial Barrier Integrity

To determine the effect of our probiotic strains on epithelial barrier integrity, Caco-2 and T84 cells were grown in a Transwell system and challenged with E. coli K12 or AIEC HM615 in combination with each of the potential probiotics; TEER and bacterial translocation were measured. Both Caco-2 and T84 cells formed stable monolayers after 8-10 days. Neither L. acidophilus ASF360 nor S. thermophilus JB010 (NCIMB 41856) had any effect on TEER alone. However, S. thermophilus JB010 (NCIMB 41856) blocked the passage of E. coli K12 through the monolayer, a phenomenon not seen with L. acidophilus ASF360 which enhanced the passage of E. coli K12 across the barrier (FIG. 6). In addition, S. thermophilus JB010 (NCIMB 41856) reduced the response to E. coli K12, by increasing TEER, in a way that L. acidophilus ASF360 did not; when S. thermophilus JB010 (NCIMB 41856) and E. coli K12 were added to the monolayer simultaneously, an increase in TEER was seen (peaking at 33% in Caco-2 cells at 6 hours and 30% in T84 cells at 10 hours compared to K12 stimulated cells), whereas L. acidophilus ASF360 and E. coli K12 together caused a decrease in TEER (peaking at 56% in Caco-2 cells at 8 hours and 11% in T84 cells at 6 hours compared to K12 stimulated cells) (FIGS. 2 and 3). While AIEC HM615 alone slowly migrated through the monolayer, both L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) appeared to interact with this strain and facilitate its migration across the epithelial monolayer. In this situation, translocation of L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) was increased until these probiotic strains were present in equal numbers to the pathogenic strain (FIG. 6). The potentially probiotic E. coli strain Nissle 1917, similarly to L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856), had no effect on TEER (FIGS. 2 and 3) but it was able to translocate quickly without the need to interact with pathogenic E. coli strains (FIG. 6).

Maintenance of Tight Cell Junctions

Caco-2 and T84 cells were grown in a Transwell system and infected with AIEC HM615; S. thermophilus JB010 (NCIMB 41856) was added to determine its effect on the tight cell junction protein occludin. AIEC HM615 caused the breakdown of tight cell junctions in Caco-2 and T84 monolayers, illustrated by decreased occludin (61% and 56% respectively) (FIG. 7). AIEC HM615 also caused a 24% decrease in nuclear staining of T84 cells (data not shown), indicating that it was inducing cell death. The addition of S. thermophilus JB010 (NCIMB 41856) to the monolayers in conjunction with AIEC HM615 prevented AIEC-induced tight cell junction breakdown and cell death; levels of nuclear and occludin staining were unchanged from control monolayers (FIG. 7).

Skewing of Effector T Cell Responses

Leukocytes were isolated from the intestinal lamina propria and challenged with bacterial antigens from E. coli K12 and AIEC HM615 to determine the effect of competing probiotic antigens from L. acidophilus ASF360, S. thermophilus JB010 (NCIMB 41856), and E. coli Nissle 1917. Both E. coli K12 and AIEC HM615 induced a Th1 response, indicated by upregulation of mRNA encoding the Th1-specific transcription factor T-box21 in the population of cultured leukocytes (16% (p=0.003) and 13% (p=0.007) respectively); this was significantly reduced by the addition of L. acidophilus ASF360 or S. thermophilus JB010 (NCIMB 41856). L. acidophilus ASF360 reduced the response to E. coli K12 and AIEC HM615 by 13% (p=0.003) and 11% (p=0.02), respectively. S. thermophilus JB010 (NCIMB 41856) reduced the Th1 response to E. coli K12 and AIEC HM615 by 10% (p=0.03) and 13% (p=0.04), respectively. E. coli Nissle 1917 also downregulated the Th1 response to AIEC HM615 by 21% (p=0.009). Furthermore, S. thermophilus JB010 (NCIMB 41856) reduced the baseline level of transcription of T-box21 in untreated cells by 6% (p=0.03). Neither E. coli strain induced a significant Th2 response but the Th17-specific transcription factor, RORC, was also upregulated following treatment with E. coli K12 or AIEC HM615 antigens (9% and 13% (p=0.02), respectively). The Th17 response to E. coli K12 was reduced by 12% following the addition of L. acidophilus ASF360 antigens (p=0.009) and the response to AIEC HM615 was reduced by the addition of any of the three potential probiotic strains: L. acidophilus ASF360 reduced the response by 18% (p=0.0002), S. thermophilus JB010 (NCIMB 41856) by 15% (p=0.003) and E. coli Nissle 1917 by 26% (p=0.003). In addition, both L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) were capable of reducing the baseline level of RORC transcription in untreated cells by 10% (p=0.003 and p=0.04, respectively). AIEC HM615 also induced a strong Treg response, shown by the upregulation of Foxp3 by 30% (p=0.0009) in cultured leukocytes. However, this was reduced by the addition of any of the three potential probiotic strains: L. acidophilus ASF360 caused an 18% reduction in Foxp3 expression (p=0.02), S. thermophilus JB010 (NCIMB 41856) a 21% reduction (p=0.03) and E. coli Nissle 1917 a 27% reduction (p=0.02) (FIG. 8).

T Cell Cytokine Production

In accordance with the transcription factor data previously described, both E. coli K12 and AIEC HM615 induced upregulation of TNFα mRNA in cultured leukocyte populations (9% and 12% respectively), indicating a Th1 response. Despite this, neither E. coli K12 nor AIEC HM615 induced a significant IFNγ response, although IFNγ mRNA production was increased by 15% when E. coli K12 and Nissle 1917 were used in combination (p=0.04) and decreased by 16% following treatment with L. acidophilus ASF360 (p=0.01) or by 10% following treatment with S. thermophilus JB010 (NCIMB 41856) (p=0.02) alone. The TNFα response to E. coli K12 was reduced by 16% by the addition of L. acidophilus ASF360 (p=0.03) whereas S. thermophilus JB010 (NCIMB 41856) reduced the level of TNFα mRNA produced in response to AIEC HM615 by 20% (p=0.03) (FIG. 9). As expected, there was no significant change in the production of the Th2-related cytokine IL-4. Although not significant, both E. coli strains appeared to increase the expression of IL-4δ2 mRNA, the naturally occurring antagonist of IL-4, further indicating skewing towards a Th1 response. However, evidence for a Th17 response was seen in the increased expression of IL-17 mRNA by 45% (p=0.04) following treatment with antigens derived from AIEC HM615; this appeared to be reduced by the addition of any of the three probiotic strains, although this was not statistically significant. No significant changes were seen in the expression of IL-10 mRNA, although E. coli Nissle 1917 did reduce IL-10 expression by 29% when cultured in combination with AIEC HM615; however HM615 did not induce the expression of IL-10 (FIG. 5). The transcription of TGFβ was significantly increased by lamina propria leukocytes by 14% in response to E. coli K12 (p=0.01) and by 11% in response to AIEC HM615 (p=0.009) treatment. L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) were able to reduce the induction of TGFβ mRNA by E. coli K12 by 12% (p=0.01) and 9% (p=0.006) to levels comparable to that of control cells. Similarly, L. acidophilus ASF360 and S. thermophilus JB010 (NCIMB 41856) also reduced the TGFβ response to AIEC HM615 by 12% (p=0.04) and 10% (p=0.009) respectively. E. coli Nissle 1917 was also able to reduce the expression of TGFβ mRNA induced by AIEC HM615 by 23% (p=0.01) (FIG. 9).

Adherence to Cells

Probiotic organisms are generally considered to have good adherence to intestinal cells in the same manner as commensal gut organisms and possibly even to mimic the adherence of invasive strains of enteric bacteria. In this respect, the present inventors tested the adherence of S. thermophilus JB010 (NCIMB 41856), S. thermophilus JB021, E. coli K12, E. coli HM427, and E. coli HM615 to Caco-2 cells.

Caco-2 human adenocarcinoma cells were grown in DMEM supplemented with 10% FCS, 2 mM L-glutamine and 100 U/ml penicillin/streptomycin in 12-well tissue culture plates at an initial density of 3×10⁵ cells/well. After 3 days of culture, the medium was replaced with antibiotic-free DMEM and S. thermophilus or E. coli strains were added at an MOI of 30. Plates were set up in duplicate (each containing 3 replicate wells/treatment) and after 4 hours of incubation at 37° C. with 5% CO₂ one set of cells were lysed with PBS containing 1% Triton X-100 and the number of live bacteria counted using the Miles and Misra method to give total number of bacteria. To give numbers of bacteria which had invaded the epithelial cells, the second set of cells was treated with PBS containing 100 μg/ml gentamicin for 2 hours at room temperature before being lysed and the bacteria being counted. The number of adherent bacteria was calculated by subtracting the number of invasive bacteria from the total number of bacteria. The results are shown in FIG. 18. From the results it can be seen that the adherent invasive strains of E. coli such as E. coli HM427 and E. coli HM615 showed a significantly higher level of adherence than either of the S. thermophilus strains and that, surprisingly, the S. thermophilus JB010 (NCIMB 41856) showed the worst adherence of all of the strains tested, showing that it would not normally be considered to be a useful probiotic strain.

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The invention claimed is:
 1. A composition comprising: a) a probiotic ingredient comprising a Streptococcus thermophilus spp. comprising SEQ ID NO:1 or SEQ ID NO:2 or Streptococcus thermophilus deposited under accession number NCIMB 41856; and b) a pharmaceutically acceptable ingredient chosen from gelatin, cellulose, starch, excipient, binder, anti-caking agent, preservative, or combination thereof; wherein the probiotic ingredient is stabilized by the pharmaceutically acceptable ingredient such that the probiotic ingredient is able to survive, reproduce, and grow at a pH level of 2 or lower for at least two hours such that the probiotic ingredient provides beneficial effects to the gastrointestinal tract.
 2. The composition of claim 1, wherein the Streptococcus thermophilus spp. is the major probiotic ingredient.
 3. The composition of claim 1, wherein the Streptococcus thermophilus spp. is the sole probiotic ingredient.
 4. The composition of claim 1, wherein the composition is a food, a food supplement, a nutraceutical, or a therapeutic.
 5. The composition of claim 1, wherein the composition is a milk-based product.
 6. The composition of claim 5, wherein the milk-based product is a fermented milk product, a yoghurt product, or a fruit-based product.
 7. The composition of claim 1, wherein the composition is a non-dairy product.
 8. The composition of claim 7, wherein the non-dairy product is a soya milk product, a soya yoghurt product, or a fruit-based product.
 9. The composition of claim 1, wherein the composition is in the form of a powder, a capsule, or tablet.
 10. The composition of claim 9, wherein the capsule or tablet has an enteric coating.
 11. A method for treating an intestinal condition in a human or animal, the method comprising orally administering to the human or animal the composition of claim
 1. 12. The method of claim 11, wherein the intestinal condition is a chronic condition or an acute condition.
 13. The method of claim 12, wherein the chronic condition is Crohn's disease, ulcerative colitis, irritable bowel syndrome, coeliac disease, gastroenteritis, pancreatitis, or combination thereof.
 14. The method of claim 12, wherein the acute condition is an ulcer, bacterial infection, parasitic infestation, protozoal infestation, injury, trauma, surgery, stress, or combination thereof.
 15. The method of claim 11, wherein the intestinal condition is associated with an increase in noradrenaline, an increase in bioavailability of iron in the intestine, or a combination thereof.
 16. The method of claim 15, wherein the increase in bioavailability of iron is due to inflammation, intestinal bleeding, surgery, trauma, stress, or a combination thereof. 